Vaccines to prevent and treat autoimmune diseases.

The current therapy for human autoimmune disease is based on nonselective immunosuppression achieved by corticosteroids or cytotoxic drugs. This form of therapy is toxic and frequently not effective in curing the disease. The study of experimental autoimmune disease models indicates that the pathogenic population of immune cells is restricted in terms of T-cell receptor gene usage and peptide epitopes recognized in the self-antigens. The recent developments in understanding of the pathophysiology of autoimmune disease point to the crucial role of the pathogenic T cell, the autoantigenic peptide, and the major histocompatibility complex molecules as well as the regulatory T-cell population in the disease process. The purpose of this review is to describe the use of vaccines to prevent and treat autoimmune disease. Encouraging results in animal models using vaccines based on the pathogenic T cell or the autoantigen have prompted the design of novel and selective immune-based therapies for human autoimmune disease.